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Infection génitale à chlamydia chez l’homme et retentissement sur la fécondité

Chlamydia genital infection in men repercution on fertility

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Resume

Chlamydia trachomatis agent de la maladie sexuellement transmise la plus fréquente, est une bactérie dont le métabolisme intracellulaire particulier conditionne la persistance et l’évolution vers la chronicité et l’inflammation. L’infection chez l’homme a souvent été associée à une altération de la fécondité attribuée à des dégradations tissulaires, fonctionnelles et même immunologiques du tractus génital et des spermatozoïdes. La détection deChlamydia trachomatis dans le sperme, déjà difficile par les méthodes de culture cellulaire et d’immunofluorescence directe, devient possible grâce aux techniques d’amplification génique, et permet de déterminer une prévalence de l’infection dans le sperme à l’intérieur de 6 groupes de patients explorés en andrologie. La détermination des IgG sériques et des IgA séminales antiC. trachomatis associée a la PCR constitue un groupe de marqueurs devenus indispensables dans l’exploration de la pathologie génitale masculine et dans le bilan d’infertilité.

Abstract

Chlamydia trachomatis is responsible for the most common sexually transmitted disease, up to 40% of the non gonococcal urethritis. It is a compulsary intracellular parasite. Its peculiar metabolism makes the bacteria interfere with the host cell immunity. Infection can become chronic and induce inflammation, if not properly treated, by permanent emission of antigens and heat shock proteins, and stimulation of Tcells. Autoimmunization against sperm can occur and impair fertilization and embryo implantation. Thus, Chlamydial infection can be associated with male infertility because of tissue damage, altered movement and antisperm immunization. PCR and LCR are to date the most sensitive detection techniques for c.trachomatis. Our study aim was to determine the prevalence of Chlamydial infection by PCR in 6 groups of men in andrologic practice. The highest prevalences have been found in the infertile men group and in the symptomatic group. No Chlamydia culture was found positive in any group. The association of PCR with anti C. trachomatis seminal IgA and seric IgG are useful tools for andrologic exploration.

References

  1. 1.

    Aitken R.J. et Irvine D.S.: Sperm movement analysis. Serono Symposium on Male Factor Infertility, Hopital Americain de Neuilly sur Seine, Mai 1994.

  2. 2.

    Askienazy-Elbhar M, Rostocker J, Dolivo M, Izard V, et al.: Correlation between serologic anti Chlamydia trachomatis IgG and secretory seminal and Chlamydia Trachomatis IgA titers in men. International 8 th Symposium on Human Chlamydial infection, Chantilly Juin 1994, Abstract accepted.

  3. 3.

    Auroux M, De Mouy D, etAcar J.: Male fertility and positive chlamydia serology. A study of 61 fertile and 82 subfertile men. Journal of Andrology. May June 1987, 8: 197–200.

  4. 4.

    Bene M. C.: Immunité des muqueuses: une voie diagnostique? Symposium d’Immunologie Biomerienc, Paris, Mars 1994.

  5. 5.

    Bianchi A, Scieux C, Brunat N, et al.: An evaluation of the polymerase chain reaction amplicor Chlamydia Trachomatis in male urine. ISSTDR Helsinki August 1993.

  6. 6.

    Bjerke S, Purvis K: Chlamydial serology in the investigation of infertility. Human Reproduction, 1992, 7, 5, 621–624.

  7. 7.

    Close CF, Wang SP, Roberts PJ, et al.: The relationship of infection with Chlamydia Trachomatis to the parameters of male infertility and sperm autoimmunity. Fertil Steril 1987, 48, 88.

  8. 8.

    Dan M, Samra Z, Siegel YI, et al.: Isolation of Chlamydia Trachomatis from prostatic tissue of patients undergoing transurethral prostatectomy. Infection 1991; 19, 162–3.

  9. 9.

    Djukic D, Nedeljkovic M, Slavic M and Stepanovic S.: Serological study of Chlamydia trachomatis infection in patients with chronic prostatitis. Proceedings of European Society for Chlamydia Research, Stockholm, Sept 1992.

  10. 10.

    Dolivo M, Askienazy-Elbhar M.: Intérêt du massage prostatique pour la mise en évidence de Chlamydia Trachomatis dans l’urèthre masculin. Contraception, Fertilité, Sexualité, 1993, 21: 41.

  11. 11.

    Dolivo M, Askienazy-Elbhar M: Role de l’infection chlamydienne chronique dans l’hypofertilite masculine. Infectiologie, 1993, 47: 6–10.

  12. 12.

    Erbengi T: Ultrastructural observations on the entry of Chlamydia Trachomatis into human spermatozoa. Hum-Reprod 1993 Mar, vol 8 (3) P: 416–21, ISSN: 0268-1161.

  13. 13.

    Gaydos CA, Jang D, Welsh LE et al: Ligase chain reaction (LCR): A novel DNA.

  14. 14.

    Gerris J, Schoysman R, Piessens Denef: Role etiologique possible de Chlamydia trachomatis dans l’infertilité d’origine épididymaire. Contracept Fertil Sex, 1986, 14: 78–92.

  15. 15.

    Giarrochi G, Linardelli S, Papa F, et al.: Serological investigation during chlamydial infections and its role in male infertility. Pro Eur. Soc. Chlamydia Res. Stockholm, Septembre 1992.

  16. 16.

    Giarrochi G, Neri MA, Rondello G, andDe Sio G: Secretory anti-Chlamydia Trachomatis IgA in male infertility. ISSITDR, Helsinh, August 1993.

  17. 17.

    Greendale GA, Haas ST, Holbrook K, Walsh B, Schachter J, Philips RS: The relationship of Chlamydia trachomatis infection and male infertility. Am J Public Health 1993 Jul; 83 (7): 996–1001.

  18. 18.

    Henry-Suchet J, Daman M, Tannous W, Askienazy-Elbhar M: Salpingites aigues non tuberculeuses, conduite à tenir. EMC sous presse 1994.

  19. 19.

    Ingerslev HJ, Ingerslev M: Clinical findings in infertile women with circulating antibodies against spermatozoa. Fertil Steril 1980, 33, 514–20.

  20. 20.

    Jantos C, Baumgartner W, Schieffer H.G: Experimental epididymetis due to chlamydia trachomatis. Proceedings of the European Society for Chlamydia Research, Stockholm, Sept 1992.

  21. 21.

    Mazoli S, Spina C, Piccini L, Benaim G: Specific anti Chlamydia Trachomatis immune response and IgA subclasses composition in male patients affected by infertility and prostatitis. ESIDOG, Taormina, June 1992.

  22. 22.

    Morrisson R.P.: Immune responses to chlamydia are protective and pathogenic. Proceedings of the VIIth International Symposium on Human Chlamydia Infection, Cambridge University Press, Harrisson Hot Springs, 1990.

  23. 23.

    Oriel J.D.: Male genital Chlamydia Trachomatis infections. J — Infect 1992 Jul, Vol, 25 Suppl 1, 35–7, ISSN: 01634453 10 Refs.

  24. 24.

    Patton D.L, Askienazy-Elbhar M, Henry-Suchet J et al.: Detection of Chlamydia Trachomatis in fallopian tube tissues in women tubal infertility. Am Journ Ob Gyn, Juillet 94.

  25. 25.

    Poletti F, Medici MC, Alinovi, et al.: Isolation of Chlamydia Trachomatis from prostatic cells in patients affected by nonacute abacterial prostatis. J Urology, 1985, 134: 691–693.

  26. 26.

    Rostocker J, Askienazy-Elbhar M, Weber P, Jardin A, Auroux M, Soufir JC: L’infection à Chlamydia trachomatis peut provoquer chez l’homme un dysfonctionnement prostatique et épididymaire, Abstract soumis SALF, Deauville Décembre 1994.

  27. 27.

    Schemer-Ayni Y, Wallach D, Sarov I,: Inhibition of Chlamydia Trachomatis growth by recombinant tumor necrotizing factor (TNF) and the reversal effect of tryptophan. Proceedings of the European Society for Chlamydia Research, Bologna-Italy, May 30th–June 1st 1988.

  28. 28.

    Toye B, Laferriere C, Claman P, Jessamine P, andPeeling R: Association between Antibody to the Chlamydial Heat-Stock Protein and Tubal Infertility: The journal of Infectious Diseases, 1993; 168: 1236–40.

  29. 29.

    Trevor G, Cooper PH: Apologie de la fonction de l’épididyme dans l’espèce humaine. Contracept Fertil Sex, 1992 20 (30): 363–73.

  30. 30.

    Yan Den Brule et al.: Detection of Chlamydial trachomatis in semen by PCR. Fertility and Sterility, Vol. 59, n° 5, May 1993.

  31. 31.

    Villegas H, Pinon M, Shor V, Karchmer S: Electron microscopy of Chlamydia Trachomatis infection of the male genital tract. Arch-Androl 1991 Sep–Oct, Vol, 27 (2), 117–26, ISSN: 0148-5016.

  32. 32.

    Witkin S, Eremias J, Toth M, Leager W.G.: Cell mediated immune response to the recombinant 57 Kd heat shock protein of chlamydia trachomatis in women with salpingitis. J. Inf. diseases 1993, 167, 1379–83.

  33. 33.

    Witkin S.: Effect of sexual intercourse on the immunology of the female reproductive tract. Third Internaffonal Symposium on Vaginitis Vaginosis, Funchal, Portugal, January, 25–29th 1994.

  34. 34.

    Witkin S.S, Jeremias J, Grifo J andLedger W.: Detection of Chlamydia Trachomatis in semen by the polymerase chain reaction in male members of infertile couples. Am J Obset Gynecol 1993; 168; 1457–62.

  35. 35.

    Wikin S: Chlamydia IgM antibodies, sperm antibodies, and cervical colonizations in wives of asymptomatic men with Chlamydia Trachomatis in semen. ESIDOG, Taormina, June 1992.

  36. 36.

    Wolff H, Neubert U, Zebhauser M et al.: Chlamydia Trachomatis induces an inflammatory response in the male genital tract and is associated with altered semen quality. Fertil-Steril 1991 May, Vol, 55 (5), P: 1017–9, ISSN: 0015-0282.

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Askienazy-Elbhar, M., Dolivo, M., Izard, V. et al. Infection génitale à chlamydia chez l’homme et retentissement sur la fécondité. Androl. 4, 425–433 (1994) doi:10.1007/BF03034726

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Mots-clés

  • parasite intracellulaire
  • infection persistante
  • inflammation
  • PCR
  • IgA séminale anti C. trachomatis

Key words

  • Intracellular parasite
  • chronicity
  • inflammation
  • heat schock proteins
  • autoimmunity
  • PCR